Medical Control


        Medical Directors provide EMS agencies with the ability to provide pre-hospital medical care in their community.  In Texas, EMS personnel are not licensed to practice independently; their practice is considered a delegated practice with authorization granted through the Medical Director.  Two agencies regulate EMS Medical Direction in Texas, the Texas Department of State Health Services (DSHS), and the Texas State Board of Medical Examiners (TSBME).

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        Metrocrest Medical Services provides a complete system for an EMS agencies Medical Control needs.  We provide all of the necessary components for an agency to be compliant with the requirements for Medical Direction as specified in TSBME Rules, Chapter 197, which include:

(1) credentialing of EMS personnel to operate in an EMS system;

(2) establish and monitor compliance with field performance guidelines for EMS personnel;

(3) establish and monitor compliance with training guidelines;

(4) create protocols for pre-hospital care and medical aspects of patient triage, transport, transfer, dispatch, extrication, rescue, and communication by EMS;

(5) direct an effective system audit and quality assurance program;

(6) determine standards and objectives for all medically related aspects of operation of the EMS;

(7) function as the primary liaison between the EMS administration and the local medical community;

(8) develop a letter or agreement or contract between the medical director(s) and the EMS administration outlining the specific responsibilities and authority of each. The agreement should describe the process or procedure by which a medical director may withdraw responsibility for EMS personnel for noncompliance with the Emergency Medical Service Act, the Health and Safety Code, Chapter 773, the rules adopted in this chapter, and/or accepted medical standards;

(9) take or recommend appropriate remedial or corrective measures for EMS personnel, in conjunction with local EMS administration, which may include, but are not limited to, counseling, retraining, testing, probation, and/or field preceptorship;

(10) suspend a certified EMS individual from medical care duties for due cause pending review and evaluation;

(11) establish the circumstances under which a patient might not be transported;

(12) establish the circumstances under which a patient may be transported against his or her will in accordance with state law, including approval of appropriate procedures, forms, and a review process;

(13) establish criteria for selection of a patient's destination; and

(14) develop and implement a comprehensive mechanism for management of patient care incidents, including patient complaints, allegations of substandard care, and deviations from established protocols and patient care standards.

Above excerpted from the TSBME Rules, Chapter 197

For additional information see Texas Administrative Code Title 25, Chapter 157 which provides requirements for EMS agencies and the Texas Health and Safety Code, Chapter 773, Emergency Medical Services Act.